TESTIMONY
Dr. Celia Quinn on Childhood Vaccination Programs and Efforts in New York City
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9 min
Dr. Celia Quinn discusses New York City's comprehensive childhood vaccination programs, emphasizing their importance and detailing efforts to enhance vaccine access and compliance.
- Dr. Quinn stresses the critical role of vaccinations in protecting against numerous diseases, including hepatitis B, diphtheria, and HPV.
- Highlights the utilization of the Citywide Immunization Registry (CIR) for surveillance, reporting, and guiding vaccination strategies.
- Outlines various vaccine access channels, such as the Vaccines for Children program and school-based health centers.
- Discusses the impact of the COVID-19 pandemic on vaccination rates among children and the efforts to recover these rates.
- Advocates for increased HPV vaccination coverage and underscores the role of healthcare providers in encouraging vaccination compliance.
Dr. Celia Quinn
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Great.
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Thank you.
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Good afternoon.
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Chair's Schulman and Moiya and members of the committee on health and the sub committee on COVID and infectious diseases.
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My name is Doctor.
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Sealy acquin, and I'm the deputy commissioner for the division of Disease Control, the New York City Department of Health And Mental Hygiene.
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I'm very pleased to be here to discuss the important topic of childhood vaccination.
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As a pediatrician and also a parent of school age children myself, I have special appreciation for the critical role of vaccination to childhood, family, and community health.
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Today, we'll be discussing a number of vaccines, all of which are safe and effective.
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In the United States, vaccine recommendations are driven by the advisory committee on immunization practices, which all to his ACIP or ASAP.
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This is a committee of medical and public health experts who are charged with providing guidance on vaccination for the country.
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There are more than 10 different types of vaccines recommended for children in their 1st 2 years of life, most of which require a series of 2 or more doses spread out across various time periods in order to provide complete protection.
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This includes vaccinations that protect against hepatitis B, rotovirus, diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hemophilus, influenza type B, varicella, and pneumococcal infection.
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It's important for children to get these vaccines according to the ACIP recommended schedule so that they start building protection when they're young and the most vulnerable to these infectious diseases.
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As kids grow older, additional vaccines are recommended, including vaccines that protect against meningococcal infection and human papillomavirus or HPV.
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In addition, all children six months or older should get their annual flu shot and any updated COVID 19 vaccine recommended by ACIP.
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The health department has robust vaccination programming to help children in New York City get the vaccines that they need to stay healthy and prevent or limit the spread of infectious diseases in our communities.
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Our work focuses in four areas.
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Reporting and surveillance, education and outreach, vaccine access, and compliance with school and childcare vaccination requirements.
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Reporting and surveillance allow us to identify populations at higher risk for vaccine preventable disease and guide our education, outreach, and vaccine access programming.
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Required disease reporting by laboratories and healthcare providers enables us to quickly identify and respond to cases or outbreaks of vaccine preventable disease and reduce the risk of further spread.
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We use surveillance data in a variety of programming, including our perinatal hepatitis B program which provides case management for pregnant and postpartum people with hepatitis B to ensure that their exposed newborns get appropriate vaccinations and other follow-up care.
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Providers in New York City are required to report all vaccines administered to children eighteen years of age and younger to the health departments citywide immunization registry, which we call CIR, with their consent, immunizations administered to adults may also be reported as well.
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The CIR is central to almost all of our vaccination programming.
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Reporting enables us to estimate vaccination coverage within different groups.
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We use characteristics such as age, race, ethnicity, and neighborhood of residents to identify coverage gaps and address inequities through targeted outreach and improving vaccine access.
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The CIR also provides real time clinical decision support to providers so they know when a child is due for a vaccine which is important given the complexity of the childhood vaccination schedule.
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Providers can also pull vaccination coverage reports for their own practice and use the CIR itself tools and CIR to send text messages to their patients.
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The CIR further serves as a platform for providers who participate in our VAC seen access programs to order vaccines and monitor their stock.
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Finally, the CIR enables people to access their and their minor children's vaccination records through the city's My Vaccine Records website.
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The health department also works hard to educate New Yorkers on the importance of vaccination.
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For example, we run an annual back to school multimedia campaign, highlighting the safety of vaccines and reminding parents of school vaccination requirements.
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The fall 2023 campaign, IVAX, WeVAX, GetVAX, urged all New Yorkers, including children to get their updated COVID 19 and flu vaccines.
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By sharing reasons why these vaccines are so important.
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This campaign ran on television, radio, digital channels, newspapers, subway digital liveboards, and the Staten Island Ferry.
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We also work with New York City public schools on letters to parents about vaccination recommendations and requirements.
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To quickly reach a large number of New Yorkers, we send text message blasts such as when COVID 19 vaccines became available to children and to remind people when they are their child may be due for another dose.
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While these efforts are important, we recognize that healthcare providers are the best and most trusted vaccine messengers A provider recommendation is the single most important factor in vaccination decisions.
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For this reason, we have extensive provider education programming, including webinars, monthly provider office hours, dear colleague letters, and guidance documents, The topics we cover in these materials are diverse from vaccine ordering and administration to building vaccine confidence.
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Since the fall of 2023, we have also been working hard to ensure providers are aware of the new RSV vaccine for pregnant people and a new monoclonal antibody both of which protect infants against RSV.
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Another area of focus for us is HPV.
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We're proud of our PD provider toolkit launched in 2017 and updated just last year.
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The toolkit includes online education and webinar trainings, information on how to talk to parents about the HPV vaccine and patient handouts.
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We also visit individual provider practices to develop customized strategies that address gaps in their HPV vaccination coverage.
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I want to take this opportunity to remind New Yorkers that the HPV vaccine is lifesaving and every child should get all recommended doses of this vaccine, which has been shown to be highly effective at protecting against cancers caused by HPV These include cervical cancer.
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Unfortunately, HPV immunization rates have plateaued, and more than half of New York City adolescents are not fully protected against HPV by the age of thirteen as recommended by ACIP.
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Council members, I would like to enlist your support in driving up our HPV vaccination coverage rates so that we can eliminate HPV causing cancers as a public health threat.
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The health department is also working to ensure that everyone in our city has access to back scenes.
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For children in particular, the best place to get vaccinated is with their primary care provider.
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Having regular checkups with a pediatrician in the 1st few years of life is vital for children's overall health and well-being.
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For this reason, the vaccines for children program is central to our childhood vaccination efforts.
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The health department administers this federally funded program, which provides vaccines to pediatric and family practices at no cost for eligible The about 1300 participating providers across New York City administer millions of free vaccines to children every year.
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Vaccines are also available at the city's school based health centers at New York City Health And Hospital sites and at the health department's immunization clinic in Brooklyn regardless of immigration status or ability to pay.
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People needing help finding a vaccination site for their child can call 311 And for COVID-nineteen and flu, they can visit the city's vaccine find our website.
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Finally, the health department works with parents, providers, and New York City School.
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On compliance with childcare and school immunization requirements.
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This includes conducting audits of immunization records at a sample of schools, encouraging schools to complete the New York State Immunization Compliance Survey, providing guidance to school staff on requirements and tracking compliance and sharing data.
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Help department physicians also review every immunization medical exemption request.
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Religious exemptions are not allowed in New York State.
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Currently, 95% of students attending public and charter schools in grades pre k through 12 are in compliance with immunization requirements.
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We are working closely with New York City public schools, providers, and parents to bring up that number even further to ensure our students and schools remain safe.
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Despite all this work, we still have not returned to pre pandemic levels of vaccination coverage in children in New York City.
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Vaccination rates declined during the pandemic as people put off routine and preventative healthcare visits.
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Students were disconnected from school based health centers and schools switched to remote learning.
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Vaccine hesitance, vaccine fatigue, and misinformation about vaccines have been associated with the pandemic.
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These declines in vaccine rates have been observed throughout the United States.
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While vaccination rates have mostly recovered from that initial drop, we we are still seeing the effects of the pandemic today.
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Vaccination rates are down approximately 2 to 16 percentage points compared with 2019 depending on the vaccine and age group that we're looking at.
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We continue to see concerning delays in vaccination with parents waiting until children enter day care school or camp to get their children vaccinated.
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While we're concerned by these decreases, we are confident that the city can return to high levels of vaccine coverage through our extensive vaccination programming and with the support of city council and other community leaders.
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We urge parents to check-in with their child's health care provider to make sure kids are up to date on their vaccines to protect their and their families' health and the health of their community.
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Thank you for the opportunity to discuss this important topic of childhood vaccination, and I look forward to answering your questions.
